| NPI | 1497435150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.028796) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.432628) |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2025-04-07 |